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Is the Serum Cholesterol‐Coronary Heart Disease Relationship Modified by Activity Level in Older Persons?
Author(s) -
Harris Tamara B.,
Makuc Diane M.,
Kleinman Joel C.,
Gillum Richard F.,
Curb J. David,
Schatzkin Arthur,
Feldman Jacob J.
Publication year - 1991
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1991.tb02695.x
Subject(s) - medicine , coronary heart disease , cholesterol , serum cholesterol , coronary disease , cardiology , gerontology
Although coronary heart disease remains a leading cause of death and disability in old age, the relationship of serum cholesterol level to risk of coronary heart disease in old age is controversial. Data for 2,388 white persons aged 65–74 who participated in the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow‐up Study (NHEFS) were examined to determine the relationship of serum cholesterol level to coronary heart disease incidence and whether activity level would modify this relationship. While there was no overall relationship between serum cholesterol level and coronary heart disease risk in either men or women, the relationship between serum cholesterol level and coronary heart disease differed within activity groups. For persons who were more active, serum cholesterol level was associated with a graded increase in risk of coronary heart disease, from 1.3 (95% CI 0.7,2.3) in those with serum cholesterol level of 4.7–5.1 to 1.7 in those with serum cholesterol level of 6.2 mmol/L or more (95% CI 1.0,2.7), when compared with those with serum cholesterol level below 4.7. For the least active persons, all levels of cholesterol were associated with a significant inverse relative risk, including cholesterol of 6.2 mmol/L or more (Relative risk = 0.4 (95% CI 0.2,0.7)). These data suggest that factors such as activity level may modify the serum cholesterol‐coronary heart disease association in old age. The serum cholesterol‐coronary heart disease association in more active older persons resembles that seen in younger populations, whereas the association in less active persons is that of serum cholesterol level and risk of cancer or death. The modification of the serum cholesterol‐coronary heart disease association by activity level may have implications for appropriate clinical management as well as appropriate design of research studies of this association.